2026 HRS/EHRA Scientific Statement on Pulsed Field Ablation for Cardiac Arrhythmias

February 12, 2026 — The Heart Rhythm Society (HRS), in collaboration with the European Heart Rhythm Association (EHRA), released 2026 HRS/EHRA Scientific Statement on Pulsed Field Ablation for Cardiac Arrhythmias.

Pulsed field ablation (PFA) is an emerging nonthermal ablation modality that has rapidly gained attention for the treatment of cardiac arrhythmias. This scientific statement provides a comprehensive overview of the technology, including its underlying mechanisms, current clinical evidence, and potential role in contemporary electrophysiology practice.

The document highlights the unique mechanism of action of PFA, which uses electroporation to selectively target myocardial tissue while minimizing injury to surrounding structures. This tissue selectivity represents a significant advancement over traditional thermal ablation approaches and may improve procedural safety.

In addition to foundational science, the statement reviews clinical applications of PFA across a range of arrhythmias, with particular emphasis on atrial fibrillation. It summarizes available data on procedural efficacy, safety outcomes, and early real-world experience, while also addressing important considerations for workflow integration and operator training.

Key themes include:

• Mechanisms of electroporation and tissue selectivity
• Clinical evidence supporting PFA in atrial fibrillation and other arrhythmias
• Safety profile compared with thermal ablation techniques
• Procedural considerations, including workflow and technology adoption
• Ongoing research and future directions for PFA

The statement also identifies current knowledge gaps and emphasizes the need for continued investigation as PFA technology evolves. Areas of interest include long-term outcomes, broader arrhythmia applications, and comparative effectiveness with established ablation modalities.

Overall, this document provides a comprehensive framework for understanding pulsed field ablation and its potential to transform the treatment of cardiac arrhythmias, supporting clinicians as they evaluate and integrate this technology into practice.